PCOS – Polycystic Ovary Syndrome
Polycystic ovary syndrome (PCOS) is the most common hormonal condition, affecting an estimated 10-20% of females. The name PCOS can be confusing as many women with the condition don’t have ovarian cysts at all. Rather, PCOS represents a set of hormonal “imbalances” that affect the entire body for the lifespan.
Patients with a family history of PCOS or diabetes are more at risk and the World Health Organization estimates that 116 million or more women are affected worldwide. Studies have found that up to 75% of individuals are undiagnosed, yet continue to suffer with the symptoms of PCOS.
PCOS is a complex hormonal condition affecting the entire body, including hormones, metabolism, fertility, and the brain and immune system. PCOS has genetic and epigenetic origins, and certain environmental and dietary factors can make it worse.
PCOS Diagnosis
PCOS may be diagnosed when a woman has two of the three following criteria:
Anovulation (lack of ovulation) or delayed ovulation
Anovulation is characterized by more than a span of 35 days between periods.
High levels of androgens
Polycystic ovaries seen on an ultrasound
This is more common in younger women and often disappears with age.
PCOS Symptoms
PCOS can cause a wide variety of stressful and troublesome symptoms. To make matters even more challenging, these symptoms can change at different times of life.
Symptoms of PCOS Include:
- cycles that are absent or far apart
- acne, especially cystic or jawline acne
- boils and hydradenitis suppuritiva
- hair loss, particularly on the top of the head
- hirsutism or hair growth on the face, chest and under the belly-button
- infertility or subfertility
- abdominal weight gain
- difficulty losing weight despite working hard at diet/exercise
- skin tags
- darkened skin patches or hyperpigmentation (acanthosis nigricans)
- mood disorders including anxiety, depression and eating disorders
- chronic low grade inflammation
- fatty liver disease
Naturopathic Testing for PCOS
Polycystic Ovary Syndrome varies from patient to patient and changes throughout the lifespan. As a result your ND will order a custom panel of tests suited to your case and your health goals.
For women who are cycling these are performed on specific cycles days. For those who aren’t cycling, that’s OK – we can run these tests anytime.
Some of the tests we commonly order for patients with PCOS include:
- Progesterone and Estradiol (timed typically 5-7 days after ovulation if cycling)
- FSH and LH (timed on cycle day 2 or 3 of the cycle)
- Total Testosterone
- Androstenedione
- Free Testosterone
- DHEA-S
- Sex Hormone Binding Globulin
- Fasting Insulin or the 2 Hour Insulin Glucose Challenge
- hs-crp
- HBA1C
- Cortisol
- Thyroid panel (TSH, free T3, free T4, Thyroid Autoantibodies)
- DUTCH testing for hormone metabolites
Naturopathic Treatment of PCOS
PCOS includes a wide spectrum of types and the way it affects a woman can change throughout her life. Women with PCOS have very different needs in times of adolescence, during the reproductive years and through the perimenopausal transition and post menopause. We always focus on what you need, when you need it, with our unique approach to PCOS.
Our Treatments May Include:
- Natural Supplements to manage insulin resistance and inflammation in PCOS
- Sustainable Dietary Approaches to Increase Insulin Sensitivity
- Cyclic Bio-Identical Progesterone Therapy to Reduce Androgens and Regulate Cycles
- Anti-Androgenic Botanical/Herbal Medicines including custom formulations
- Management of hypothyroidism or Hashimoto’s Thyroiditis (commonly associated with PCOS)
- Naturopathic Approaches for Adrenal Androgen Excess and Stress in PCOS
- Naturopathic Fertility care specific for PCOS for those trying to conceive
- Assistance in Discontinuing Oral Contraceptive Medications
- Support for the Unique Needs for Mood and Mental Health in PCOS
- PCOS-Specific Environmental Health guidance
Naturopathic Nutrition for Classic or Insulin-Resistant PCOS
Naturopathic Medicine for Lean PCOS
Lean PCOS is a condition which can be very confusing to practitioners and patients alike. Many patients with lean PCOS may not have significant insulin resistance and often are placed on restrictive diets with little to no benefit.
These diets can be stressful and don’t address the root causes of problems in lean PCOS. However, some patients with lean PCOS may have milder insulin resistance or reactive hypoglycemia, so it is important to identify these elements if present.
For lean PCOS we identify the levels of insulin resistance and hypoglycemia and focus on the root cause of hormonal imbalance. A careful diagnosis of imbalances of androgens, progesterone, estradiol, FSH and LH and rebalancing these key underlying causes is the best approach to the treatment of lean PCOS.
